EMERGENCY Departments are under ‘extreme pressure’ as the country continues to ease Covid restrictions.

Emergency department clinicians have raised concerns over their ability to provide high quality care due to increasing patient admissions.

At a Health Board meeting on July 15, members were given an update on the improvement programme of work for the whole urgent and emergency care system that will ultimately avoid harm, ensure delivery of high clinical standards and quality of care, improved patient outcomes and provide a better experience for patients and staff.

Gill Harris, Executive Director of Nursing and Midwifery, said the extreme pressure on emergency departments have been increased by things such as needing to test patients, managing the red and green pathways depending on results and a reduction in beds due to social distancing requirements.

Although this ‘isn’t unique to North Wales’, emergency departments are ‘certainly seeing the pressure’. and they are not seeing access to care home beds as previously seen.

She told members of an increase in tourism in North Wales which is ‘way beyond’ anything previously seen which non-local people accessing emergency services.

People are also presenting with needs who did not step forward during the pandemic that are now presenting unscheduled care services.

Ms Harris said there are concerns also over the number of patients waiting in emergency departments and an improvement programme is underway – but this will not be a ‘magic bullet’.

They have been able to resource that programme including analytic support to see a precise picture of what is happening in the emergency departments across the region.

She said they recognise pressures all staff are working under and they do have 'locality plans' which are beginning to formulate.

She said: “This is not a target, it’s a standard we should be applying to people using our services.

“We serve the public, we shouldn’t forget that.”

In a report shown to members, for the six months from January to June 2021, the Health Board has reported a total of 104 instances when sites reported escalation level 4, this is split per site as follows; Ysbyty Gwynedd 13, Wrexham Maelor 25 and Ysbyty Glan Clwyd 66.

The report states that overcrowding is felt more acutely due to a variety of factors, despite the rate of new infections decreasing.

Emergency Department pressures ED Clinical Leads wrote to the Acting Chief Executive back in December regarding the significant levels of overcrowding and highlighted their concerns around the impact on their ability to deliver safe, effective care.

A meeting was held to discuss concerns and the necessary actions required to ensure that improvements are delivered to ensure patient safety, reduce harm and support staff to be able to deliver the high standards of clinical care they aspire to.

A Health Board wide learning lessons event will be held in August, bringing together all the Emergency Departments to reflect and share the outcomes of serious incident investigations across the three sites.

The report states that the Health Board has recognised the need for improvement across the urgent and emergency care system.

Six goals for urgent and emergency care have been identified which includes:

  • Co-ordination, planning and support for high risk groups
  • Signposting to the right place, first time
  • Access to clinically safe alternatives to admission to hospital
  • Rapid response in a physical or mental health crisis
  • Optimal hospital care following admission
  • Homefirst approach and reduce the risk of readmission